Drug-resistant malaria infection threatens world health systems

The case of Ka Lar Nar, a Myanmar farmer who contracted malaria for the sixth time while working away from home in the jungle of south-eastern Myanmar has given indication that there are drug-resistant malaria parasites threatening to prove medical doctors and pharmaceutical companies ineffective at treating malarial conditions.

Ka Lar Nar had been placed on malaria drugs given from a community health center, but still remains unwell after three days of treatment and with the malaria parasites still remaining visible in his blood system. His fever is not really subsided and he continues to have headaches and experience related feverish conditions.

Health authorities now suspect that Lar Nar could be suffering from drug-resistant malaria infection, and this might cause a global scare if not quickly reined in as it spreads through Myanmar to other countries along the Mekong River basin; putting countries like India at risk as the disease moves through to Africa in what might become a global health emergency.

According to Eisa Hamid, an epidemiologist working with the UN in Myanmar to monitor and evaluate malaria programs, “With any patient showing positive test results after three days of treatment, we have to suspect drug resistance, and more sophisticated blood testing should have been done as he could still carry the parasites that cause malaria in his blood.”

Health authorities believe that Myanmar has the largest malaria incidence within the region, and since it is located between the Andaman Sea and the Himalayas as it borders India and China, the country is well positioned to stop the spread of malaria and its resistance to drugs as it spreads to India and Africa.

“We need to act fast to avoid a big catastrophe,” said Pascal Ringwald of the WHO’s Global Malaria Programme. “The consequences could be disastrous.” And Nyan Sint, an epidemiologist and regional malaria officer working with the government’s national malaria control program, adds that “Artemisinin resistance could wipe out a lot of the gains we’ve made in containing malaria and there is nothing yet to replace it.”

It is estimated that an extra 116,000 deaths per year could result if artemisinin resistance is not stopped; and medical costs could exceed $32 million per year, while productivity losses from a rise in cases and deaths are estimated at $385 million.